WO2004032800A1 - Device for connection between a corporeal duct and a prosthesis - Google Patents

Device for connection between a corporeal duct and a prosthesis Download PDF

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Publication number
WO2004032800A1
WO2004032800A1 PCT/FR2003/002988 FR0302988W WO2004032800A1 WO 2004032800 A1 WO2004032800 A1 WO 2004032800A1 FR 0302988 W FR0302988 W FR 0302988W WO 2004032800 A1 WO2004032800 A1 WO 2004032800A1
Authority
WO
WIPO (PCT)
Prior art keywords
sleeve
prosthesis
pins
intubated
conduits
Prior art date
Application number
PCT/FR2003/002988
Other languages
French (fr)
Inventor
Jean-François Garbe
Original Assignee
Garbe Jean-Francois
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Garbe Jean-Francois filed Critical Garbe Jean-Francois
Priority to DK03780211T priority Critical patent/DK1549252T3/en
Priority to DE60318597T priority patent/DE60318597T2/en
Priority to AU2003288310A priority patent/AU2003288310A1/en
Priority to US10/530,801 priority patent/US7828834B2/en
Priority to EP03780211A priority patent/EP1549252B1/en
Publication of WO2004032800A1 publication Critical patent/WO2004032800A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2/064—Blood vessels with special features to facilitate anastomotic coupling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
    • A61B2017/00557—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated inflatable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B2017/1107—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis for blood vessels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2/07—Stent-grafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/848—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents having means for fixation to the vessel wall, e.g. barbs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2002/065—Y-shaped blood vessels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2/07—Stent-grafts
    • A61F2002/075—Stent-grafts the stent being loosely attached to the graft material, e.g. by stitching

Definitions

  • the present invention relates to the installation of a tubular prosthesis attached either to one end of a body conduit, or between two body conduits to be connected, by intubation of one or both ends of the prosthesis in the body duct (s) and fixation of the intubated parts using a connecting device which is the subject of the invention.
  • a first solution consists in directly connecting the conduits together using manual surgical sutures.
  • Another solution consists in using a tubular prosthesis, in the form of a sleeve, the two ends of which are intubated respectively in the two conduits to be connected, means being provided for joining together the intubated parts of the prosthesis and the end parts of said conduits. .
  • document US 4 21 4 587 also discloses an anastomosis device for two vessels using an elastically radially compressible annular element provided externally with pins. This element must be compressed to reduce its diameter in order to be introduced into the terminal part of the duct to be anastomosed. Once released, it expands to take its nominal diameter.
  • annular element ceasing to expand while the intubated part is perhaps not perfectly pressed against the part. end of the conduit to be connected, such an element is necessarily dimensioned for a very reduced range of diameters of conduits to be anastomosed, which means making a range of annular elements of various diameters and choosing precisely the element most suitable for each anastomosis.
  • the subject of the invention is a connection device between the previously intubated ends of a body conduit and of a prosthesis of substantially tubular shape, characterized in that it consists of a sleeve with a mesh structure or analog deformable using a balloon catheter and capable of radial expansion between a stable configuration of minimum diameter and a final configuration after expansion also stable, said sleeve comprising, at each end, a series of pins for transfixing the overlapping parts of the sleeve, regularly aligned in a crown and oriented radially, said pins having a hemostatic profile comprising a base part of circular section extended by a terminal part of trihedral shape.
  • the expandable sleeve consists of a perforated steel cylinder according to diamond-shaped cuts and the pins are attached and fixed by welding or gluing to the intersections of the sides of said diamonds.
  • said sleeve is capable of expanding in a diameter ratio in a transfixion to initial diameter situation greater than 2.
  • the out-of-ends part of the sleeve is also provided with transfixion pins.
  • the spikes in the crown of the ends of the sleeve are rectilinear and the other spikes are slightly curved with their point oriented towards one or the other of the ends of the sleeve or any other direction, in a random manner.
  • the invention applies to the connection between one end of a prosthesis and the terminal part of a body conduit such as an artery with a diameter between 6 mm and 30 mm, but it also applies to the junction between two body conduits via a prosthesis, the two ends of which are intubated in the end portions of the two conduits to be abutted.
  • FIG. 1A is a perspective view of an embodiment of the connection device of the invention in its configuration of minimum diameter
  • FIG. 1B represents the device of FIG. 1A deployed in its configuration of maximum diameter
  • FIG. 2A is an elevation view of a pin
  • FIG. 2B illustrates the trihedral profile of the tip of the pin of FIG. 2A
  • FIG. 3 is a view illustrating the fixing of a prosthesis on a body conduit using the connection device of the invention
  • - Figure 4 is a diagram illustrating the establishment and attachment of a first body conduit to a first end of a prosthesis
  • - Figure 5 is a diagram illustrating the establishment and attachment of a second conduit body at the second end of the prosthesis
  • FIG. 6 illustrates the application of the method to the establishment of devices according to the invention on a bifurcated prosthesis.
  • the device of the invention ensures the connection between a prosthesis 1 0 and a body conduit 1 2, in which one of the ends of the prosthesis 1 0 is intubated.
  • This connecting device more particularly intended for vascular conduits can be adapted to any other bodily conduit in which a prosthesis is likely to be intubated.
  • the prosthesis of shape adapted to the body conduit, generally substantially tubular, is not described in more detail since it is within the reach of those skilled in the art.
  • the prosthesis is usually in Dacron ®. It may be a straight tubular prosthesis or bifurcated in Y.
  • the connecting device 1 4 between the prosthesis 1 0 and the body conduit 1 2 comprises an expandable sleeve 1 6 disposed inside of the prosthesis, an embodiment of which is shown in FIGS. 1 A and 1 B.
  • Figure 1 A is shown schematically a tubular sleeve 1 6 in openwork steel in its configuration of minimum diameter, that is to say as it is at the end of manufacture, ready to be used.
  • the sleeve 1 6 is for example produced by laser cutting of a suitable steel tube with a wall thickness of a few tenths of a millimeter, with a diameter of 8 mm and a length of 24 mm.
  • the cutouts are diamond-shaped so as to produce a regular mesh structure whose branches 1 8 separating the diamonds 20 have, by way of illustration, a length of a few millimeters for example 4 mm for a width of the order of a few tenths of a millimeter.
  • Figures 1 A and 1 B simply illustrate the general structure of the sleeve 1 6 and that the dimensional ratios indicated above are not observed in the drawings.
  • at the two ends of the sleeve 1 6 of the transfer pins 22 are regularly distributed in a crown radially outward from the external face of the sleeve.
  • the pins 22 are made of steel and attached for example by welding or gluing to the end points 24 of the sleeve 1 6.
  • the pins 22 have a length of between approximately 0.5 mm and 3 mm and are straight. Their profile is hemostatic and comprises a cylindrical base part 26, with a diameter of the order of a few tenths of a millimeter, extended by an end part 28 of trihedral shape. As with the mesh structure, the pins 22 of FIGS. 1 A and 1 B are not shown in full size.
  • all the points 24 of the two ends of the sleeve 1 6 are provided with pins 22.
  • the pins 22 of the ends may be of reduced height compared to that of the pins of the intermediate zone. Indeed, when the length of the sleeve 1 6 is greater than the length of the intubated overlapping parts, the end parts of the sleeve are located opposite a single wall to be transfixed so that the pins in these areas can have a reduced height, having less wall thickness to pass through than the other pins of the sleeve.
  • a circular crown 30 of spikes 22 ' In the central zone of the sleeve 1 6 is arranged a circular crown 30 of spikes 22 ', at the rate of a spike every two intersections. Between the central crown 30 and each end ring of pins 22 is arranged another ring of pins 22 'identical to the ring 30. The distribution of pins 22' is regular or not.
  • the pins 22 ' have the profile shown in FIGS. 2A and 2B, namely a hemostatic profile of the type of the pins 22, with a cylindrical base 32 extended by a terminal tip with a trihedral profile 34 (FIG. 2B).
  • the terminal tip 34 is preferably curved in the direction of one or other of the ends of the sleeve 1 6 or in any other direction, the pins 22 'preferably having different orientations, the inclination of said end portions 34 being between 0 and 10 ° and preferably around 5 °.
  • Figure 1 B shows the sleeve 1 6 of Figure 1 A in the expanded state, the length of the mesh structure being reduced from 24 mm to 20 mm and the diameter from 8 mm to 20 mm.
  • Said structure is not elastic, has no shape memory and is dimensionally stable whatever the amplitude of the expansion which will be given to it, the latter being applied to it using an inflatable balloon of a conventional bloating catheter, when the connection device of the invention is put in place as will now be described with reference to FIGS. 3 to 5.
  • connection device in the body conduit
  • the connecting device 1 is arranged to the inside of the prosthesis 10 in line with the area of overlap of the body conduit 1 2 and of the prosthesis 1 0.
  • the pins 22, 22 ′ perforate both the prosthesis and the body conduit so as to ensure the connection between the two elements.
  • the invention also applies to the anastomosis of two bodily conduits via a prosthesis 10 and 1 2.2, the two ends of which are intubated in the terminal parts of said conduits.
  • connection device comprises two connection devices 1 4-1 and 1 4-2 constituted for example by a sleeve 1 6 of the type of FIG. 1, arranged respectively at each end at inside the prosthesis 10.
  • the invention also relates to a method of setting up the connecting devices.
  • the body duct 1 2.1 is intubated a first end of the prosthesis 10.
  • the first connecting device 1 4.1 is introduced inside the prosthesis 10 by the second end, and put in place, as illustrated by Figure 4 using an inflatable balloon 36 attached to the delivery catheter 38 in the known manner.
  • the second connecting device 14.2 ( Figure 5) is introduced via an orifice 40 formed at the level of the prosthesis 1 0, closed after placement, with manual stitches.
  • FIG. 6 there is shown a bifurcated prosthesis in Y 10 'whose first end is intubated in a first body conduit 1 2'-1 and fixed with a first sleeve 1 4'-1 according to invention using the catheter 38 inserted into the prosthesis 10 'by one of the bifurcated ends.
  • the two bifurcated ends of the prosthesis 10 ' are intubated in two other body conduits 1 2'-2 and 1 2'-3 and fixed using two others sleeves 14'-2 and 14'-3 which are successively put in place as in the case illustrated in FIG. 5 by introduction of the catheter 38 provided with the balloon 36 on which the transfixing sleeve is threaded (1 4'-2, 1 4'-3), through an orifice 40 'which will then be closed.
  • the sleeve 1 6 can expand over a large diameter range, the ratio between the final diameter, in situ, of the sleeve and the initial diameter being advantageously greater than 2, and because the final state is stable since there is no retraction of the sleeve once the deployment balloon is deflated, an effective plating of the sleeve 1 6 is carried out against the intubated facing parts, both tight and firm thanks to the pins 22, 22 'of transfixing said intubated parts.
  • the ability of the sleeve 1 6 to an expansion of variable amplitude allows using a single size sleeve to be used for anastomoses for example of vessels whose diameters can vary within a wide range, for example arteries with a diameter between 6 and 30 mm.
  • sleeves 1 6 of different sizes and having pins 22, 22 'of different shapes and dimensions and distributed on the sleeve in different ways.

Abstract

The invention concerns a device for connection between previously intubed ends of a corporeal duct (12) and a substantially tubular prosthesis (10) characterized in that it consists of a sleeve (16) with meshed structure or the like deformable by means of a balloon catheter and capable of radial expansion between a stable configuration of minimum diameter and a final configuration after expansion likewise stable, said sleeve (16) comprising, at each end, a series of teeth (22) for transfixing overlapping parts of the sleeve, uniformly aligned in a ring formation and radially oriented, said teeth (22) having a hemostatic profile including a base part (32) with circular cross-section extended by a trihedral terminal portion (34).

Description

DISPOSITIF DE LIAISON ENTRE UN CONDUIT CORPOREL ET UNE PROTHESE CONNECTION DEVICE BETWEEN A BODY CONDUIT AND A PROSTHESIS
La présente invention se rapporte à la mise en place d'une prothèse tubulaire rapportée soit à une extrémité d'un conduit corporel, soit entre deux conduits corporels à relier, par intubation de l'une des extrémités, ou des deux, de la prothèse dans le ou les conduits corporels et fixation des parties intubées à l'aide d'un dispositif de liaison objet de l'invention.The present invention relates to the installation of a tubular prosthesis attached either to one end of a body conduit, or between two body conduits to be connected, by intubation of one or both ends of the prosthesis in the body duct (s) and fixation of the intubated parts using a connecting device which is the subject of the invention.
Dans le domaine des anastomoses entre conduits corporels, une première solution consiste à relier directement les conduits entre eux à l'aide de sutures manuelles chirurgicales.In the field of anastomoses between bodily conduits, a first solution consists in directly connecting the conduits together using manual surgical sutures.
Cette solution a pour seul avantage de ne nécessiter aucun appareillage. Toutefois, le temps opératoire pour la réaliser est relativement long et la qualité de la jonction dépend de la dextérité du praticien qui doit relier deux conduits souples entre eux.The only advantage of this solution is that it does not require any equipment. However, the operating time to achieve it is relatively long and the quality of the junction depends on the dexterity of the practitioner who must connect two flexible conduits together.
Une autre solution consiste à utiliser une prothèse tubulaire, sous forme d'un manchon dont les deux extrémités sont intubées respectivement dans les deux conduits à relier, des moyens étant prévus pour solidariser entre elles les parties intubées de la prothèse et les parties terminales desdits conduits.Another solution consists in using a tubular prosthesis, in the form of a sleeve, the two ends of which are intubated respectively in the two conduits to be connected, means being provided for joining together the intubated parts of the prosthesis and the end parts of said conduits. .
Par le document WO 98/1 9631 on connaît un dispositif d'anastomose du type ci-dessus constitué d'une prothèse formée d'une structure maillée expansible dont les extrémités intubées dans les conduits à relier sont pourvues de moyens d'ancrage dans les parties terminales desdits conduits. A cet effet, chaque extrémité de la prothèse est constituée d'une structure spéciale auto-expansible munie de saillies radiales destinées à pénétrer dans le tissu des conduits pour éviter tout glissement entre ces derniers et la prothèse. Un tel dispositif n'est pas pleinement satisfaisant. D'une part, parce qu'il nécessite la réalisation d'une prothèse spéciale puisqu'elle intègre à chaque extrémité des structures particulières. D'autre part, parce-que la mise en place de la prothèse ne peut pas être effectuée à l'aide d'un cathéter à ballonnet, les parties intubées de la prothèse étant plaquées contre les parties terminales des conduits par simple auto-expansion, cette technique n'assurant pas un ancrage véritablement ferme et étanche.Document WO 98/1 9631 discloses an anastomosis device of the above type consisting of a prosthesis formed of an expandable mesh structure, the ends of which are intubated in the conduits to be connected, are provided with anchoring means in the end parts of said conduits. For this purpose, each end of the prosthesis is made up of a special self-expanding structure provided with radial projections intended to penetrate into the fabric of the conduits to avoid any sliding between the latter and the prosthesis. Such a device is not fully satisfactory. On the one hand, because it requires the realization of a special prosthesis since it integrates at each end of the particular structures. On the other hand, because the implantation of the prosthesis cannot be carried out using a balloon catheter, the intubated parts of the prosthesis being pressed against the end parts of the conduits by simple self-expansion , this technique does not ensure a truly firm and waterproof anchorage.
Par ailleurs, on connaît également par le document US 4 21 4 587 un dispositif d'anastomose de deux vaisseaux à l'aide d'un élément annulaire compressible élastiquement radialement pourvu extérieurement de picots. Cet élément doit être comprimé pour réduire son diamètre afin d'être introduit dans la partie terminale du conduit à anastomoser. Une fois relâché, il s'expanse pour prendre son diamètre nominal.Furthermore, document US 4 21 4 587 also discloses an anastomosis device for two vessels using an elastically radially compressible annular element provided externally with pins. This element must be compressed to reduce its diameter in order to be introduced into the terminal part of the duct to be anastomosed. Once released, it expands to take its nominal diameter.
Outre, l'inconvénient d'un ancrage non assuré d'être véritablement ferme et étanche comme dans le cas précédent, l'élément annulaire cessant de s'expanser alors que la partie intubée n'est peut-être pas parfaitement plaquée contre la partie terminale du conduit à relier, un tel élément est dimensionné nécessairement pour une plage très réduite de diamètres de conduits à anastomoser, ce qui impose de réaliser une gamme d'éléments annulaires de divers diamètres et de choisir avec précision l'élément le plus approprié à chaque anastomose.In addition, the disadvantage of an uninsured anchoring being truly firm and watertight as in the previous case, the annular element ceasing to expand while the intubated part is perhaps not perfectly pressed against the part. end of the conduit to be connected, such an element is necessarily dimensioned for a very reduced range of diameters of conduits to be anastomosed, which means making a range of annular elements of various diameters and choosing precisely the element most suitable for each anastomosis.
Enfin, par les documents US 5 931 842 et WO 98/1 9634, on connaît des systèmes destinés à réaliser des anastomoses mais dans le cadre particulier de pontages cardiaques, c'est-à-dire d'anastomose termino-latérale, à l'aide d'anneaux expansibles pourvus extérieurement de picots, dont aucun détail n'est donné quant à la structure de l'anneau et l'agencement des picots. La présente invention vise à pallier les inconvénients des systèmes d'anastomose connus et plus particulièrement à proposer un dispositif spécifiquement adapté aux anastomoses termino-terminales.Finally, from documents US 5,931,842 and WO 98/1 9634, systems are known which are intended to perform anastomoses but in the particular context of cardiac bypass surgery, that is to say termino-lateral anastomosis, using expandable rings externally provided with pins, no details of which are given as to the structure of the ring and the arrangement of the pins. The present invention aims to overcome the drawbacks of known anastomosis systems and more particularly to propose a device specifically adapted to end-to-end anastomoses.
A cet effet, l'invention a pour objet un dispositif de liaison entre les extrémités préalablement intubées d'un conduit corporel et d'une prothèse de forme sensiblement tubulaire, caractérisé en ce qu'il est constitué d'un manchon à structure maillée ou analogue déformable à l'aide d'un cathéter à ballonnet et susceptible d'une expansion radiale entre une configuration stable de diamètre minimal et une configuration finale après expansion également stable, ledit manchon comportant, à chaque extrémité, une série de picots de transfixion des parties en recouvrement du manchon, alignés régulièrement en couronne et orientés radialement, lesdits picots présentant un profil hémostatique comprenant une partie de base de section circulaire prolongée par une partie terminale de forme triédrique. Suivant un mode de réalisation préféré, le manchon expansible est constitué d'un cylindre d'acier ajouré suivant des découpes losangées et les picots sont rapportés et fixés par soudage ou collage aux intersections des côtés desdits losanges.To this end, the subject of the invention is a connection device between the previously intubated ends of a body conduit and of a prosthesis of substantially tubular shape, characterized in that it consists of a sleeve with a mesh structure or analog deformable using a balloon catheter and capable of radial expansion between a stable configuration of minimum diameter and a final configuration after expansion also stable, said sleeve comprising, at each end, a series of pins for transfixing the overlapping parts of the sleeve, regularly aligned in a crown and oriented radially, said pins having a hemostatic profile comprising a base part of circular section extended by a terminal part of trihedral shape. According to a preferred embodiment, the expandable sleeve consists of a perforated steel cylinder according to diamond-shaped cuts and the pins are attached and fixed by welding or gluing to the intersections of the sides of said diamonds.
Suivant une autre caractéristique du dispositif de l'invention, ledit manchon est susceptible de s'expanser dans un rapport diamètre en situation de transfixion sur diamètre initial supérieur à 2.According to another characteristic of the device of the invention, said sleeve is capable of expanding in a diameter ratio in a transfixion to initial diameter situation greater than 2.
Suivant un mode de réalisation préférentiel la partie hors-extrémités du manchon est également pourvue de picots de transfixion.According to a preferred embodiment, the out-of-ends part of the sleeve is also provided with transfixion pins.
De préférence, les picots en couronne des extrémités du manchon sont rectilignes et les autres picots sont légèrement incurvés avec leur pointe orientée vers l'une ou l'autre des extrémités du manchon ou toute autre direction, de manière aléatoire.Preferably, the spikes in the crown of the ends of the sleeve are rectilinear and the other spikes are slightly curved with their point oriented towards one or the other of the ends of the sleeve or any other direction, in a random manner.
L'invention s'applique à la liaison entre une extrémité d'une prothèse et la partie terminale d'un conduit corporel tel qu'une artère de diamètre entre 6 mm et 30 mm, mais elle s'applique également à la jonction entre deux conduits corporels via une prothèse dont les deux extrémités sont intubées dans les parties terminales des deux conduits à abouter. D'autres caractéristiques et avantages ressortiront de la description qui va suivre d'un mode de mise en oeuvre de l'invention, description donnée à titre d'exemple uniquement, en regard des dessins annexés sur lesquels:The invention applies to the connection between one end of a prosthesis and the terminal part of a body conduit such as an artery with a diameter between 6 mm and 30 mm, but it also applies to the junction between two body conduits via a prosthesis, the two ends of which are intubated in the end portions of the two conduits to be abutted. Other characteristics and advantages will emerge from the description which follows of an embodiment of the invention, description given by way of example only, with reference to the appended drawings in which:
- la figure 1 A est une vue en perspective d'un mode de réalisation du dispositif de liaison de l'invention dans sa configuration de diamètre minimal,FIG. 1A is a perspective view of an embodiment of the connection device of the invention in its configuration of minimum diameter,
- la figure 1 B représente le dispositif de la figure 1 A déployé dans sa configuration de diamètre maximal,FIG. 1B represents the device of FIG. 1A deployed in its configuration of maximum diameter,
- la figure 2A est une vue en élévation d'un picot,FIG. 2A is an elevation view of a pin,
- la figure 2B illustre le profil triédrique de la pointe du picot de la figure 2A,FIG. 2B illustrates the trihedral profile of the tip of the pin of FIG. 2A,
- la figure 3 est une vue illustrant la fixation d'une prothèse sur un conduit corporel à l'aide du dispositif de liaison de l'invention,FIG. 3 is a view illustrating the fixing of a prosthesis on a body conduit using the connection device of the invention,
- la figure 4 est un schéma illustrant la mise en place et la fixation d'un premier conduit corporel à une première extrémité d'une prothèse, - la figure 5 est un schéma illustrant la mise en place et la fixation d'un second conduit corporel à la seconde extrémité de la prothèse, et- Figure 4 is a diagram illustrating the establishment and attachment of a first body conduit to a first end of a prosthesis, - Figure 5 is a diagram illustrating the establishment and attachment of a second conduit body at the second end of the prosthesis, and
- la figure 6 illustre l'application du procédé à la mise en place de dispositifs selon l'invention sur une prothèse bifurquée.- Figure 6 illustrates the application of the method to the establishment of devices according to the invention on a bifurcated prosthesis.
Comme illustré sur la figure 3, le dispositif de l'invention permet d'assurer la liaison entre une prothèse 1 0 et un conduit corporel 1 2, dans lequel l'une des extrémités de la prothèse 1 0 est intubée.As illustrated in Figure 3, the device of the invention ensures the connection between a prosthesis 1 0 and a body conduit 1 2, in which one of the ends of the prosthesis 1 0 is intubated.
Ce dispositif de liaison plus particulièrement destiné aux conduits vasculaires peut s'adapter à tout autre conduit corporel dans lequel est susceptible d'être intubée une prothèse. La prothèse de forme adaptée au conduit corporel, généralement sensiblement tubulaire, n'est pas décrite plus en détail car à la portée de l'homme de l'art. Selon un mode de réalisation connu, cette prothèse est le plus souvent en DACRON® . Il peut s'agir d'une prothèse tubulaire droite ou bifurquée en Y. Selon l'invention, le dispositif de liaison 1 4 entre la prothèse 1 0 et le conduit corporel 1 2 comprend un manchon expansible 1 6 disposé à l'intérieur de la prothèse dont un mode de réalisation est représenté sur les figures 1 A et 1 B.This connecting device more particularly intended for vascular conduits can be adapted to any other bodily conduit in which a prosthesis is likely to be intubated. The prosthesis of shape adapted to the body conduit, generally substantially tubular, is not described in more detail since it is within the reach of those skilled in the art. According to a known embodiment, the prosthesis is usually in Dacron ®. It may be a straight tubular prosthesis or bifurcated in Y. According to the invention, the connecting device 1 4 between the prosthesis 1 0 and the body conduit 1 2 comprises an expandable sleeve 1 6 disposed inside of the prosthesis, an embodiment of which is shown in FIGS. 1 A and 1 B.
Sur la figure 1 A est représenté schématiquement un manchon tubulaire 1 6 en acier ajouré dans sa configuration de diamètre minimal, c'est-à-dire tel qu'il se présente en fin de fabrication, prêt à être utilisé.In Figure 1 A is shown schematically a tubular sleeve 1 6 in openwork steel in its configuration of minimum diameter, that is to say as it is at the end of manufacture, ready to be used.
Le manchon 1 6 est par exemple réalisé par découpe au laser d'un tube d'acier approprié d'épaisseur de paroi de quelques dixièmes de millimètre, de diamètre 8 mm et de longueur 24 mm. Les découpes sont losangées en sorte de réaliser une structure maillée régulière dont les branches 1 8 séparant les losanges 20 présentent, à titre illustratif, une longueur de quelques millimètres par exemple 4 mm pour une largeur de l'ordre de quelques dixièmes de millimètre. Il est à noter que les figures 1 A et 1 B illustrent simplement la structure générale du manchon 1 6 et que les rapports dimensionnels indiqués ci-dessus ne sont pas respectés sur les dessins. Conformément à l'invention, aux deux extrémités du manchon 1 6 des picots 22 de transfixion sont régulièrement répartis en couronne radialement vers l'extérieur à partir de la face externe du manchon.The sleeve 1 6 is for example produced by laser cutting of a suitable steel tube with a wall thickness of a few tenths of a millimeter, with a diameter of 8 mm and a length of 24 mm. The cutouts are diamond-shaped so as to produce a regular mesh structure whose branches 1 8 separating the diamonds 20 have, by way of illustration, a length of a few millimeters for example 4 mm for a width of the order of a few tenths of a millimeter. It should be noted that Figures 1 A and 1 B simply illustrate the general structure of the sleeve 1 6 and that the dimensional ratios indicated above are not observed in the drawings. According to the invention, at the two ends of the sleeve 1 6 of the transfer pins 22 are regularly distributed in a crown radially outward from the external face of the sleeve.
Les picots 22 sont en acier et rapportés par exemple par soudage ou collage sur les pointes d'extrémité 24 du manchon 1 6. Les picots 22 ont une longueur comprise entre environ 0,5 mm et 3 mm et sont rectilignes. Leur profil est hémostatique et comprend une partie de base 26 cylindrique, d'un diamètre de l'ordre de quelques dixièmes de millimètre, prolongée par une partie terminale 28 de forme triédrique. De même que la structure maillée les picots 22 des figures 1 A et 1 B ne sont pas représentés en vraie grandeur.The pins 22 are made of steel and attached for example by welding or gluing to the end points 24 of the sleeve 1 6. The pins 22 have a length of between approximately 0.5 mm and 3 mm and are straight. Their profile is hemostatic and comprises a cylindrical base part 26, with a diameter of the order of a few tenths of a millimeter, extended by an end part 28 of trihedral shape. As with the mesh structure, the pins 22 of FIGS. 1 A and 1 B are not shown in full size.
De préférence, toutes les pointes 24 des deux extrémités du manchon 1 6 sont munies de picots 22.Preferably, all the points 24 of the two ends of the sleeve 1 6 are provided with pins 22.
Les picots 22 des extrémités peuvent être de hauteur réduite par rapport à celle des picots de la zone intermédiaire. En effet, lorsque la longueur du manchon 1 6 est supérieure à la longueur des parties intubées en recouvrement, les parties d'extrémité du manchon se trouvent en regard d'une seule paroi à transfixier en sorte que les picots dans ces zones peuvent avoir une hauteur réduite, ayant moins d'épaisseur de paroi à traverser que les autres picots du manchon.The pins 22 of the ends may be of reduced height compared to that of the pins of the intermediate zone. Indeed, when the length of the sleeve 1 6 is greater than the length of the intubated overlapping parts, the end parts of the sleeve are located opposite a single wall to be transfixed so that the pins in these areas can have a reduced height, having less wall thickness to pass through than the other pins of the sleeve.
Sur la face externe du manchon 1 6 délimitée entre les deux couronnes de picots 22 d'extrémité sont également, dans le mode de réalisation représenté, implantés des picots 22', aux intersections des branches 1 8 de la structure maillée et plus précisément à certaines intersections seulement.On the outer face of the sleeve 1 6 delimited between the two crowns of end pins 22 are also, in the embodiment shown, implanted pins 22 ', at the intersections of the branches 1 8 of the mesh structure and more precisely at certain intersections only.
Dans la zone centrale du manchon 1 6 est agencée une couronne circulaire 30 de picots 22', à raison d'un picot toutes les deux intersections. Entre la couronne centrale 30 et chaque couronne de picots 22 d'extrémité est agencée une autre couronne de picots 22' identique à la couronne 30. La distribution des picots 22' est régulière ou non.In the central zone of the sleeve 1 6 is arranged a circular crown 30 of spikes 22 ', at the rate of a spike every two intersections. Between the central crown 30 and each end ring of pins 22 is arranged another ring of pins 22 'identical to the ring 30. The distribution of pins 22' is regular or not.
De préférence, les picots 22' ont le profil représenté en figure 2A et 2B, à savoir un profil hémostatique du type des picots 22, à base 32 cylindrique prolongée par une pointe terminale à profil triédrique 34 (figure 2B) . En outre, la pointe terminale 34 est de préférence incurvée en direction de l'une ou l'autre des extrémités du manchon 1 6 ou selon toute autre direction, les picots 22' ayant de préférence des orientations différentes, l'inclinaison desdites parties terminales 34 étant comprise entre 0 et 10° et, de préférence de l'ordre de 5 ° . La figure 1 B représente le manchon 1 6 de la figure 1 A à l'état expansé, la longueur de la structure maillée étant réduite de 24 mm à 20 mm et le diamètre passant de 8 mm à 20 mm.Preferably, the pins 22 'have the profile shown in FIGS. 2A and 2B, namely a hemostatic profile of the type of the pins 22, with a cylindrical base 32 extended by a terminal tip with a trihedral profile 34 (FIG. 2B). In addition, the terminal tip 34 is preferably curved in the direction of one or other of the ends of the sleeve 1 6 or in any other direction, the pins 22 'preferably having different orientations, the inclination of said end portions 34 being between 0 and 10 ° and preferably around 5 °. Figure 1 B shows the sleeve 1 6 of Figure 1 A in the expanded state, the length of the mesh structure being reduced from 24 mm to 20 mm and the diameter from 8 mm to 20 mm.
Ladite structure n'est pas élastique, ne présente pas de mémoire de forme et est stable dimensionnellement quelle que soit l'amplitude de l'expansion qui lui sera donnée, cette dernière lui étant appliquée à l'aide d'un ballon gonflable d'un cathéter à ballonnement conventionnel, lors de la mise en place du dispositif de liaison de l'invention comme on va maintenant le décrire en référence aux figures 3 à 5.Said structure is not elastic, has no shape memory and is dimensionally stable whatever the amplitude of the expansion which will be given to it, the latter being applied to it using an inflatable balloon of a conventional bloating catheter, when the connection device of the invention is put in place as will now be described with reference to FIGS. 3 to 5.
L'utilisation d'un tel dispositif de liaison est relativement simple et décrite au regard de la figure 3. De manière connue, dans le conduit corporelThe use of such a connection device is relatively simple and described with regard to FIG. 3. In a known manner, in the body conduit
1 2 est intubée l'extrémité de la prothèse 10, sur une longueur de l'ordre de 25 mm. Le dispositif de liaison 1 4, très schématisé sur la figure 3, est disposé à l'intérieur de la prothèse 10 au droit de la zone de recouvrement du conduit corporel 1 2 et de la prothèse 1 0. Lors de l'expansion du manchon 1 6, les picots 22, 22' perforent à la fois la prothèse et le conduit corporel de manière à assurer la liaison entre les deux éléments. L'invention s'applique également à l'anastomose de deux conduits corporels via une prothèse 10 et 1 2.2 dont les deux extrémités sont intubées dans les parties terminales desdits conduits.1 2 is intubated the end of the prosthesis 10, over a length of about 25 mm. The connecting device 1 4, very schematically in Figure 3, is arranged to the inside of the prosthesis 10 in line with the area of overlap of the body conduit 1 2 and of the prosthesis 1 0. When the sleeve 1 6 expands, the pins 22, 22 ′ perforate both the prosthesis and the body conduit so as to ensure the connection between the two elements. The invention also applies to the anastomosis of two bodily conduits via a prosthesis 10 and 1 2.2, the two ends of which are intubated in the terminal parts of said conduits.
Comme illustré par les figures 4 et 5, le dispositif de connexion comprend deux dispositifs de liaison 1 4-1 et 1 4-2 constitués par exemple par un manchon 1 6 du type de la figure 1 , disposés respectivement au niveau de chaque extrémité à l'intérieur de la prothèse 10.As illustrated by FIGS. 4 and 5, the connection device comprises two connection devices 1 4-1 and 1 4-2 constituted for example by a sleeve 1 6 of the type of FIG. 1, arranged respectively at each end at inside the prosthesis 10.
L'invention a également pour objet un procédé de mise en place des dispositifs de liaison.The invention also relates to a method of setting up the connecting devices.
A cet effet, dans le conduit corporel 1 2.1 est intubée une première extrémité de la prothèse 10. Le premier dispositif de liaison 1 4.1 est introduit à l'intérieur de la prothèse 10 par la seconde extrémité, et mis en place, comme illustré par la figure 4 à l'aide d'un ballon gonflable 36 rapporté sur le cathéter 38 de mise en place à la manière connue.For this purpose, in the body duct 1 2.1 is intubated a first end of the prosthesis 10. The first connecting device 1 4.1 is introduced inside the prosthesis 10 by the second end, and put in place, as illustrated by Figure 4 using an inflatable balloon 36 attached to the delivery catheter 38 in the known manner.
Puis conformément à l'invention, dans le second conduit corporel 1 2.2 est ensuite intubée la seconde extrémité de la prothèse 1 0, puis le second dispositif de liaison 14.2 (figure 5) est introduit via un orifice 40 ménagé au niveau de la prothèse 1 0, refermé après la mise en place, par des points de suture manuelle.Then according to the invention, in the second body duct 1 2.2 is then intubated the second end of the prosthesis 1 0, then the second connecting device 14.2 (Figure 5) is introduced via an orifice 40 formed at the level of the prosthesis 1 0, closed after placement, with manual stitches.
Grâce à l'utilisation du dispositif de liaison de l'invention, les temps opératoires nécessaires sont réduits, permettant de réduire les risques de mortalité.Thanks to the use of the inventive binding device, the necessary operating times are reduced, making it possible to reduce the risks of mortality.
Sur la figure 6, on a représenté une prothèse bifurquée en Y 10' dont une première extrémité est intubée dans un premier conduit corporel 1 2'-1 et fixée à l'aide d'un premier manchon 1 4'-1 selon l'invention à l'aide du cathéter 38 introduit dans la prothèse 1 0' par l'une des extrémités bifurquées. Les deux extrémités bifurquées de la prothèse 10' sont intubées dans deux autres conduits corporels 1 2'-2 et 1 2'-3 et fixées à l'aide de deux autres manchons 14'-2 et 14'-3 qui sont mis en place successivement comme dans le cas illustré par la figure 5 par introduction du cathéter 38 muni du ballon 36 sur lequel est enfilé le manchon de transfixion (1 4'-2, 1 4'-3), au travers d'un orifice 40' qui sera ensuite refermé. Du fait que le manchon 1 6 peut s'expanser dans une plage de diamètres importante, le rapport entre le diamètre final, in situ, du manchon et le diamètre initial étant avantageusement supérieur à 2, et du fait que l'état final est stable puisqu'il n'y a pas de rétraction du manchon une fois le ballon de mise en place dégonflé, on réalise un plaquage efficace du manchon 1 6 contre les parties intubées en regard, à la fois étanche et ferme grâce aux picots 22, 22' de transfixion desdites parties intubées.In Figure 6, there is shown a bifurcated prosthesis in Y 10 'whose first end is intubated in a first body conduit 1 2'-1 and fixed with a first sleeve 1 4'-1 according to invention using the catheter 38 inserted into the prosthesis 10 'by one of the bifurcated ends. The two bifurcated ends of the prosthesis 10 'are intubated in two other body conduits 1 2'-2 and 1 2'-3 and fixed using two others sleeves 14'-2 and 14'-3 which are successively put in place as in the case illustrated in FIG. 5 by introduction of the catheter 38 provided with the balloon 36 on which the transfixing sleeve is threaded (1 4'-2, 1 4'-3), through an orifice 40 'which will then be closed. Because the sleeve 1 6 can expand over a large diameter range, the ratio between the final diameter, in situ, of the sleeve and the initial diameter being advantageously greater than 2, and because the final state is stable since there is no retraction of the sleeve once the deployment balloon is deflated, an effective plating of the sleeve 1 6 is carried out against the intubated facing parts, both tight and firm thanks to the pins 22, 22 'of transfixing said intubated parts.
De plus, l'aptitude du manchon 1 6 à une expansion d'amplitude variable permet à l'aide d'un manchon de taille unique d'être utilisé pour des anastomoses par exemple de vaisseaux dont les diamètres peuvent varier dans une plage étendue, par exemple des artères de diamètre compris entre 6 et 30 mm.In addition, the ability of the sleeve 1 6 to an expansion of variable amplitude allows using a single size sleeve to be used for anastomoses for example of vessels whose diameters can vary within a wide range, for example arteries with a diameter between 6 and 30 mm.
On peut cependant et bien entendu, suivant les applications, réaliser des manchons 1 6 de différentes tailles et comportant des picots 22, 22' de différentes formes et dimensions et distribués sur le manchon de différentes manières. One can however and of course, depending on the applications, make sleeves 1 6 of different sizes and having pins 22, 22 'of different shapes and dimensions and distributed on the sleeve in different ways.

Claims

R E V E N D I C A T I O N S
1 . Dispositif de liaison entre les extrémités préalablement intubées d'un conduit corporel (1 2) et d'une prothèse (1 0) de forme sensiblement tubulaire, caractérisé en ce qu'il est constitué d'un manchon (1 6) à structure maillée ou analogue déformable à l'aide d'un cathéter à ballonnet et susceptible d'une expansion radiale entre une configuration stable de diamètre minimal et une configuration finale après expansion également stable, ledit manchon ( 1 6) comportant, à chaque extrémité, une série de picots (22) de transfixion des parties en recouvrement du manchon, alignés régulièrement en couronne et orientés radialement, lesdits picots (22) présentant un profil hémostatique comprenant une partie de base (32) de section circulaire prolongée par une partie terminale (34) de forme triédrique.1. Connection device between the previously intubated ends of a body conduit (1 2) and of a prosthesis (1 0) of substantially tubular shape, characterized in that it consists of a sleeve (1 6) with a mesh structure or the like deformable using a balloon catheter and capable of radial expansion between a stable configuration of minimum diameter and a final configuration after expansion also stable, said sleeve (1 6) comprising, at each end, a series pins (22) for transfixing the overlapping parts of the sleeve, regularly aligned in a crown and oriented radially, said pins (22) having a hemostatic profile comprising a base part (32) of circular section extended by a terminal part (34) of trihedral form.
2. Dispositif suivant la revendication 1 , caractérisé en ce que le manchon expansible (1 6) est constitué d'un cylindre d'acier ajouré suivant des découpes losangées (20) et les picots (22, 22') sont rapportés et fixés par soudage ou collage aux intersections des côtés desdits losanges (20) .2. Device according to claim 1, characterized in that the expandable sleeve (1 6) consists of a perforated steel cylinder according to diamond-shaped cuts (20) and the pins (22, 22 ') are attached and fixed by welding or bonding at the intersections of the sides of said diamonds (20).
3. Dispositif suivant la revendication 1 ou 2, caractérisé en ce que la partie hors-extrémités du manchon (1 6) est également pourvue de picots de transfixion (22') .3. Device according to claim 1 or 2, characterized in that the off-end part of the sleeve (1 6) is also provided with transfixion pins (22 ').
4. Dispositif suivant l'une des revendications 1 à 3, caractérisé en ce que ledit manchon (1 6) est susceptible de s'expanser dans un rapport diamètre en situation de transfixion sur diamètre initial supérieur à 2.4. Device according to one of claims 1 to 3, characterized in that said sleeve (1 6) is capable of expanding in a diameter ratio in the transfixion to initial diameter situation greater than 2.
5. Dispositif suivant l'une des revendications 1 à 4, caractérisé en ce que les picots (22) en couronne des extrémités du manchon (1 6) sont rectilignes et les autres picots (22') sont légèrement incurvés avec leur pointe (34) orientée vers l'une ou l'autre des extrémités du manchon (1 6) ou toute autre direction, de manière aléatoire.5. Device according to one of claims 1 to 4, characterized in that the pins (22) in the crown of the ends of the sleeve (1 6) are straight and the other pins (22 ') are slightly curved with their tip (34 ) oriented towards either end of the sleeve (1 6) or any other direction, randomly.
6. Dispositif suivant la revendication 5, caractérisé en ce que lesdits picots (22') présentent une partie terminale (34) inclinée d'un angle compris entre 0 et 10°, de préférence 5° . 6. Device according to claim 5, characterized in that said pins (22 ') have an end portion (34) inclined at an angle between 0 and 10 °, preferably 5 °.
7. Dispositif suivant l'une des revendications 1 à 6, caractérisé en ce que les picots (22) des extrémités du manchon (16) sont de hauteur réduite par rapport à celle des autres picots (22').7. Device according to one of claims 1 to 6, characterized in that the pins (22) of the ends of the sleeve (16) are of reduced height compared to that of the other pins (22 ').
8. Dispositif de liaison appliqué à l'anastomose termino-terminale d'au moins deux conduits corporels (12-1, 12-2 ; 12'-1, 12'-2, 12'-3) par l'intermédiaire d'une prothèse (10,10') dont les extrémités sont intubées dans les parties terminales desdits conduits, caractérisé en ce qu'il est constitué d'un manchon (16) selon l'une quelconque des revendications 1 à 7, engagé dans chaque extrémité de la prothèse (10,10') en regard des parties intubées. 8. Connection device applied to the end-to-end anastomosis of at least two bodily conduits (12-1, 12-2; 12'-1, 12'-2, 12'-3) via a prosthesis (10,10 ') whose ends are intubated in the end parts of said conduits, characterized in that it consists of a sleeve (16) according to any one of claims 1 to 7, engaged in each end of the prosthesis (10,10 ') opposite the intubated parts.
9. Procédé de mise en place de dispositifs de liaison selon la revendication 8, caractérisé en ce qu'une première extrémité de la prothèse (10,10') est intubée dans l'extrémité d'un premier conduit corporel (12-1 ; 12'-1), un premier dispositif de liaison (14-1,14'-1) est mis en place à l'aide d'un cathéter (38) à ballon gonflable (36) introduit dans la prothèse (10,10') par l'autre ou une autre extrémité, puis l'autre extrémité ou les autres extrémités de la prothèse (10,10') sont intubées dans l'autre conduit (12-2) ou les autres conduits (12'-2, 12'-3) et, enfin, le deuxième dispositif de liaison (14-2) ou les deuxième et troisième dispositifs de liaison (14'-2, 14'-3) sont mis en place à l'aide dudit cathéter (38) introduit dans la prothèse (10,10') au travers un orifice (40,40') ménagé dans ladite prothèse et refermé ensuite. 9. A method of installing connecting devices according to claim 8, characterized in that a first end of the prosthesis (10,10 ') is intubated in the end of a first body conduit (12-1; 12'-1), a first connecting device (14-1,14'-1) is put in place using a catheter (38) with an inflatable balloon (36) inserted into the prosthesis (10,10 ') by the other or another end, then the other end or the other ends of the prosthesis (10,10') are intubated in the other conduit (12-2) or the other conduits (12'-2 , 12'-3) and, finally, the second connecting device (14-2) or the second and third connecting devices (14'-2, 14'-3) are placed using said catheter ( 38) introduced into the prosthesis (10,10 ') through an orifice (40,40') formed in said prosthesis and then closed.
PCT/FR2003/002988 2002-10-10 2003-10-10 Device for connection between a corporeal duct and a prosthesis WO2004032800A1 (en)

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DK03780211T DK1549252T3 (en) 2002-10-10 2003-10-10 Connecting device between a body canal and a prosthesis
DE60318597T DE60318597T2 (en) 2002-10-10 2003-10-10 CONNECTING DEVICE BETWEEN A BODY CHANNEL AND A PROSTHESIS
AU2003288310A AU2003288310A1 (en) 2002-10-10 2003-10-10 Device for connection between a corporeal duct and a prosthesis
US10/530,801 US7828834B2 (en) 2002-10-10 2003-10-10 Device for connection between a corporeal duct and a prosthesis
EP03780211A EP1549252B1 (en) 2002-10-10 2003-10-10 Device for connection between a corporeal duct and a prosthesis

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FR02/12601 2002-10-10
FR0212601A FR2845590B1 (en) 2002-10-10 2002-10-10 DEVICE FOR CONNECTION BETWEEN A PROSTHESIS AND A BODY CONDUIT AND DEVICE FOR CONNECTING TWO BODY CONDUITS DISPOSED AT END-TO-END

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EP (1) EP1549252B1 (en)
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AU (1) AU2003288310A1 (en)
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DK (1) DK1549252T3 (en)
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FR2845590A1 (en) 2004-04-16
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DE60318597T2 (en) 2008-12-24
US20060149349A1 (en) 2006-07-06
DK1549252T3 (en) 2008-05-19
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DE60318597D1 (en) 2008-02-21
PT1549252E (en) 2008-04-17
EP1549252A1 (en) 2005-07-06
US7828834B2 (en) 2010-11-09
EP1549252B1 (en) 2008-01-09
ATE383127T1 (en) 2008-01-15

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